| Marielena Cecilia Vasquez, MD | |
|
6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905-2102 | |
| (624) 082-2737 | |
| Not Available |
| Full Name | Marielena Cecilia Vasquez |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 6600 Van Aalst Blvd Bldg 9250, Fort Moore, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841311347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 001912 (Georgia) | Secondary |
| 208000000X | Pediatrics | 62790 (Georgia) | Primary |
| Entity Name | Emergency Group Of Columbus Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316458227 PECOS PAC ID: 2668735515 Enrollment ID: O20180406001191 |
| Mailing Address | Practice Location Address |
|---|---|
| Marielena Cecilia Vasquez, MD 6600 Van Aalst Boulevard, Martin Army Community Hospital, Fort Moore, GA 31904 Ph: () - | Marielena Cecilia Vasquez, MD 6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905-2102 Ph: (624) 082-2737 |
Graeme Philip Bloomfield, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 6600 Van Aalst Blvd, Fort Moore, GA 31905 Phone: 660-031-9057 | |
Afsheen Siddique, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905 Phone: 762-408-0374 | |
Brittany Bumgardner, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905 Phone: 762-408-2273 | |
Ayesha Mejia Nettles, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905 Phone: 762-408-2273 Fax: 762-408-8101 |